Addressing the Third Delay: an obstetric triage system to reduce delay and improve quality care

Delay in receiving care within a hospital—the “third delay”—accounts for thousands of maternal and newborn deaths each year. Patients with time-sensitive complications often arrive late, in compromised states, and wait for hours. Actions to quickly assess and treat high-risk women are critical to survival. Kybele developed the first obstetric triage system for use in low resource countries. The approach has transformed a “first come, first serve” mindset by introducing new tools and problem solving skills. Piloted in Ghana at a high volume, referral hospital, median wait times decreased from 40 to 5 minutes and the maximum wait times from 26.5 to 5.6 hours. Ninety-three percent of high risk patients were correctly identified and treatment plan documentation increased from 51% to 96%. Kybele is scaling this innovation to six referral hospitals in Ghana. The model is applicable for tertiary hospitals worldwide and could impact the lives of millions of pregnant patients and their babies.